scholarly journals Bedside clinical assessment predicts recurrence after hospitalization due to viral lower respiratory tract infection in young children

2019 ◽  
Vol 68 (3) ◽  
pp. 756-761 ◽  
Author(s):  
Maria Arroyo ◽  
Kyle P Salka ◽  
Geovanny F Perez ◽  
Carlos E Rodriguez-Martinez ◽  
Jose A Castro-Rodriguez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Tract Infection ◽  
Young Children ◽  
Early Life ◽  
Lower Respiratory Tract ◽  
Individual Risk ◽  
Respiratory Illnesses ◽  
History Of ◽  
Individual Risk Factors

Infants requiring hospitalization due to a viral lower respiratory tract infection (LRTI) have a high risk of developing recurrent respiratory illnesses in early life and asthma beyond childhood. Notably, all validated clinical scales for viral LRTI have focused on predicting acute severity instead of recurrence. We present a novel clinical approach combining individual risk factors with bedside clinical parameters to predict recurrence after viral LRTI hospitalization in young children. A retrospective longitudinal cohort of young children (≤3 years) designed to define clinical predictive factors of recurrent respiratory illnesses within 12 months after hospitalization due to PCR-confirmed viral LRTI. Data collection was through electronic medical record. We included 138 children hospitalized with viral LRTI. Using automatic stepwise logistic model selection, we found that the strongest predictors of recurrence in infants hospitalized for the first time were severe prematurity (≤32 weeks’ gestational age, OR=5.19; 95% CI 1.76 to 15.32; p=0.002) and a clinical score that weighted hypoxemia, subcostal retractions and wheezing (OR=3.33; 95% CI 1.59 to 6.98; p<0.001). After the first hospitalization, the strongest predictors of subsequent episodes were wheezing (OR=5.62; 95% CI 1.03 to 30.62; p=0.04) and family history of asthma (OR=5.39; 95% CI 1.04 to 27.96; p=0.04). We found that integrating individual risk factors (eg, prematurity or family history of asthma) with bedside clinical assessment (eg, wheezing, subcostal retractions or hypoxemia) can predict the risk of recurrence after viral LRTI hospitalization in infants. This strategy may enable clinically oriented subsetting of infants with viral LRTI based on individual predictors for recurrent respiratory illnesses during early life.

scholarly journals The burden and correlates of multiple cardiometabolic risk factors in a semi-urban population of Nepal: a community-based cross-sectional study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Bishal Gyawali ◽  
Shiva Raj Mishra ◽  
Saruna Ghimire ◽  
Martin Rune Hassan Hansen ◽  
Kishor Jung Shah ◽  
...  
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Urban Population ◽  
Cardiometabolic Risk ◽  
Cardiometabolic Risk Factors ◽  
Individual Risk ◽  
Community Based ◽  
Family History Of Diabetes ◽  
History Of ◽  
Individual Risk Factors

Abstract This study assessed the burden and correlates of three cardiometabolic risk factors, (hypertension, diabetes, and overweight/obesity), and their possible clustering patterns in a semi-urban population of Nepal. Data were obtained from a community-based management of non-communicable disease in Nepal (COBIN) Wave II study, which included 2,310 adults aged 25–64 years in a semi-urban area of Pokhara Metropolitan City of Nepal, using the World Health Organization-STEPS questionnaire. Unadjusted and adjusted binary logistic regression models were used to study the correlates of the individual risk factors and their clustering. The prevalence of hypertension, diabetes, and overweight/obesity was 34.5%, 11.7%, and 52.9%, respectively. In total, 68.2% of the participants had at least one risk factor and many participants had two risks in combination: 6.8% for ‘hypertension and diabetes’, 7.4% for ‘diabetes and overweight/obesity’ and 21.4% for ‘hypertension and overweight/obesity’. In total, 4.7% had all three risk factors. Janajati ethnicity (1.4–2.1 times), male gender (1.5 times) and family history of diabetes (1.4–3.4 times) were associated with presence of individual risk factors. Similarly, Janajati ethnicity (aOR: 4.31, 95% CI: 2.53–7.32), current smoking (aOR: 4.81, 95% CI: 2.27–10.21), and family history of diabetes (aOR: 4.60, 95% CI: 2.67–7.91) were associated with presence of all three risk factors. Our study found a high prevalence of all single and combined cardiometabolic risk factors in Nepal. It underlines the need to manage risk factors in aggregate and plan prevention activities targeting multiple risk factors.

scholarly journals Prevalence of lower respiratory tract infection in tertiary care hospital, Thane

2021 ◽  
Vol 8 (10) ◽  
pp. 1700
Author(s):  
Shrikant Joshi ◽  
Kamil Shaikh ◽  
Vrushali V. Kulkarni
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Lower Respiratory Tract Infection ◽  
Lower Respiratory Tract ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital

Background: World health organization (WHO) predicted lower respiratory tract infections (LRTI) as primary cause of mortality world-wide. The present study was undertaken to know the various types of LRTI in children <5 years of age and analyze factors influencing the morbidity and mortality of those cases.Methods: Prospective cross-sectional study for 100 infected children with LRTI was conducted in a tertiary care hospital of metropolitan city. Demographic, clinical history and examination, necessary investigations were performed and followed regularly for desired outcome.Results: 51% children were in the age-group of 1 to 5 years who reported acute lower respiratory tract infection (ALRTI) and 49% were below 1 year age. The study reported LTRI incidence in 63% male and 37% female children whereas the family history of incidence of LRTI was present in 18% cases. Fever, cough and retraction complaints were the prominent symptoms. Hyperinflation was the major finding in chest X-ray. Streptococcus pneumoniae was the common bacterial pathogens isolated. Bronchiolitis was the commonest cause (39%) followed by lobar pneumonia (37%).Conclusions: Various types of clinical presentations, risk factors and types of LRTI in children less than 5 years of age were studied. A result of this study will be useful to understand the etiology and bacterial pathogens in management of clinical outcome. Modifiable risk factors for LRTI like family history, past history, immunization status, and malnutrition can be tackled through effective health education of the community, leading to a healthy society.

Assessing Individual Risk for Prostate Cancer

2007 ◽  
Vol 25 (24) ◽  
pp. 3582-3588 ◽  
Author(s):  
Robert K. Nam ◽  
Ants Toi ◽  
Laurence H. Klotz ◽  
John Trachtenberg ◽  
Michael A.S. Jewett ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Family History ◽  
Screening Method ◽  
Specific Antigen ◽  
Urinary Symptoms ◽  
Individual Risk ◽  
High Grade ◽  
Characteristic Analysis ◽  
History Of

Purpose To construct a clinical nomogram instrument to estimate individual risk for having prostate cancer (PC) for patients undergoing prostate specific antigen (PSA) screening, using all risk factors known for PC. Patients and Methods We conducted a cross-sectional study of 3,108 men who underwent a prostate biopsy, including a subset of 408 volunteers with normal PSA levels. Factors including age, family history of PC (FHPC), ethnicity, urinary symptoms, PSA, free:total PSA ratio, and digital rectal examination (DRE) were incorporated in the model. A nomogram was constructed to assess risk for any and high-grade PC (Gleason score ≥ 7). Results Of the 3,108 men, 1,304 (42.0%) were found to have PC. Among the 408 men with a normal PSA (< 4.0 ng/mL), 99 (24.3%) had PC. All risk factors were important predictors for PC by multivariate analysis (P, .01 to .0001). The area under the curve (AUC) for the nomogram in predicting cancer, which included age, ethnicity, FHPC, urinary symptoms, free:total PSA ratio, PSA, and DRE, was 0.74 (95% CI, 0.71 to 0.81) and 0.77 (95% CI, 0.74 to 0.81) for high-grade cancer. This was significantly greater than the AUC that considered using the conventional screening method of PSA and DRE only (0.62; 95% CI, 0.58 to 0.66 for any cancer; 0.69; 95% CI, 0.65 to 0.73 for high-grade cancer). From receiver operating characteristic analysis, risk factors including age, ethnicity, FHPC, symptoms, and free:total PSA ratio contributed significantly more predictive information than PSA and DRE. Conclusion In a PC screening program, it is important to consider age, family history of PC, ethnicity, urinary voiding symptoms, and free:total PSA ratio, in addition to PSA and DRE.

Epidemiology and causes of suicide

2020 ◽  
pp. 1279-1288
Author(s):  
Merete Nordentoft ◽  
Trine Madsen ◽  
Annette Erlangsen
Keyword(s):  
Risk Factors ◽  
Mental Disorders ◽  
Suicide Attempt ◽  
Population Attributable Risk ◽  
Public Health Problem ◽  
Individual Risk ◽  
Major Public Health Problem ◽  
East European ◽  
History Of ◽  
Individual Risk Factors

Suicide is often the outcome of a personal crisis; yet many conditions, both societal and individual, are established predictors of suicide. It remains a major public health problem worldwide, although rates of suicide vary substantially across nations. The highest rates are reported in Russia and East European countries. This chapter summarizes the existing evidence regarding societal and individual risk factors for suicide. At the societal level, risk factors such as economic crisis, social cohesiveness, and media portrayal are mentioned. Individual risk factors include sociodemographic factors, physical and mental disorders, history of suicide attempt, and suicide risk in minority groups. The risk factors associated with the highest risk are mental disorders and history of suicide attempt. Population-attributable risk calculations suggest that preventive efforts should be directed towards the excess risk associated with recent suicide attempt, mental disorders, and common social factors.

Five Risk Factors for Depression

1987 ◽  
Vol 150 (4) ◽  
pp. 536-541 ◽  
Author(s):  
A. Roy
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Young Children ◽  
Endogenous Depression ◽  
Degree Relative ◽  
History Of ◽  
One Year ◽  
Family History Of Depression ◽  
History Of Depression ◽  
At Home

Significantly more of 300 patients with non-endogenous depression compared with 300 matched controls were unemployed and had a poor marriage before the onset of depression, had a first-degree relative who had been treated for depression, had experienced separation for one year or more from a parent before 17 years of age and had three or more children under 14 years of age at home. However, significantly more of 44 patients with endogenous depression, than their 46 controls, also had a poor marriage before the onset of depression and 43% of them had a first-degree relative who had been treated for depression. Thus a family history of depression and a poor marriage before the onset of depression are associated with both non-endogenous and endogenous depression but unemployment, separation for one year or more from a parent before 17 years of age, and having three or more young children at home may be risk factors for non-endogenous depression.

scholarly journals Risk factors of pediatric urinary tract infections: an epidemiologic study

2018 ◽  
Vol 6 (1) ◽  
pp. 204
Author(s):  
Maryam Esteghamati ◽  
Seyedeh Elaheh Mousavi ◽  
Shervin Haj Alizadeh
Keyword(s):  
Risk Factors ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Family History ◽  
Tract Infection ◽  
Neurogenic Bladder ◽  
Significant Relationship ◽  
Renal Stone ◽  
Urinary Catheterization ◽  
History Of

Background: Urinary tract infection (UTI) is the second most prevalent pediatric infection, and if it is not recognized and treated properly, it can cause severe irreversible complications such as renal failure and hypertension. In this research, some of the risk factors of UTIs were compared in children with urinary tract infections.Methods: This is a cross-sectional study, with the urinary tract infection as the dependent variable and gender, circumcision status, history of urinary catheterization, family history, history of renal stone, hypercalciuria, constipation history, reflux, neurogenic bladder, phimosis, posterior urethral valves (PUV), ureteropelvic junction obstruction (UPJO), and ureterovesical junction obstruction (UVJO) as the independent variables. A total of 405 children were studied in this research. The data was collected using questionnaires, checklists, and examinations. Data analysis was also carried out using descriptive and analytical statistics method in SPSS.Results: This research revealed the prevalence of urinary tract infection among children with several risk factors, and the common factors were positive family history, history of urinary catheterization, constipation, and other non-anatomical disorders (history of renal stone and hypercalciuria. The most common risk factors regardless of gender and age were non-anatomic disorders that were observed in 147 cases (43.7%) (p-value<0.001). Among the non-anatomical factors, constipation was the most common factor observed in 66 cases (16.3%). A higher rate of urinary infection was observed in the uncircumcised male patients than the circumcised patients, and there was a significant relationship between circumcision and UTI.Conclusions: In this study, urinary tract infection staged a significant relationship with gender, circumcision status, urinary catheterization history, family history, renal stone history, hypercalciuria, history of constipation, reflux, neurogenic bladder, phimosis, PUV, UPJO, and UVJO.

scholarly journals Indoor Air Pollution as a Risk Factor of Acute Lower Respiratory Tract Infection in Children

2017 ◽  
Vol 13 (1) ◽  
pp. 5-7 ◽  
Author(s):  
Niraj Acharya ◽  
Pradip Mishra ◽  
Veena Gupta
Keyword(s):  
Air Pollution ◽  
Family History ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Indoor Air ◽  
Lower Respiratory Tract ◽  
Indoor Air Pollution ◽  
Domestic Animal ◽  
History Of

Introduction: This study was conducted to find out if indoor air pollution has any risk in occurrence of acute lower respiratory tract infection (ALRI) in children.Materials and methods: It was a case control study conducted on total 214 children 107 cases and 107 controls fulfilling the inclusion criteria with age and sex matched. Detailed history and physical examination was done after taking informed consent. History of upper respiratory tract infection in the family members and siblings, history of smoking by various family members, details of cooking fuel and indoor pollution was also recorded.Results: Those families using wood as a cooking material were associated with higher risk of ALRI (p=0.0001). Exposure to domestic animal was significantly positively associated (p=0.0001) and seven times higher risk to develop ALRI as compared to control group. Those children of case group who did not have separate kitchen were having nine times higher risk of ALRI (p=0.001). Family history of smoking was associated with six times increased risk of ALRI (p=0.001). With the use of kerosene lamps risk of ALRI was increased by 1.44 times (p=0.012).Conclusions: The significant environmental risk factors for ALRI were wood as cooking material, presence of domestic animal, place for cooking, family history of smoking, absence of windows and kerosene lamp as a source of light.Journal of Nepalgunj Medical College Vol.13(1) 2015: 5-7  

A Model for Analyzing Suicide Prevention

Crisis ◽  
2000 ◽  
Vol 21 (2) ◽  
pp. 80-89 ◽  
Author(s):  
Maila Upanne
Keyword(s):  
Risk Factors ◽  
Theoretical Model ◽  
Protective Factors ◽  
Suicide Prevention ◽  
Suicide Risk ◽  
Practical Work ◽  
Individual Risk ◽  
Self Assessment ◽  
Prevention Project ◽  
Individual Risk Factors

This study monitored the evolution of psychologists' (n = 31) conceptions of suicide prevention over the 9-year course of the National Suicide Prevention Project in Finland and assessed the feasibility of the theoretical model for analyzing suicide prevention developed in earlier studies [ Upanne, 1999a , b ]. The study was formulated as a retrospective self-assessment where participants compared their earlier descriptions of suicide prevention with their current views. The changes in conceptions were analyzed and interpreted using both the model and the explanations given by the subjects themselves. The analysis proved the model to be a useful framework for revealing the essential features of prevention. The results showed that the freely-formulated ideas on prevention were more comprehensive than those evolved in practical work. Compared to the earlier findings, the conceptions among the group had shifted toward emphasizing a curative approach and the significance of individual risk factors. In particular, greater priority was focused on the acute suicide risk phase as a preventive target. Nonetheless, the overall structure of prevention ideology remained comprehensive and multifactorial, stressing multistage influencing. Promotive aims (protective factors) also remained part of the prevention paradigm. Practical working experiences enhanced the psychologists' sense of the difficulties of suicide prevention as well as their criticism and feeling of powerlessness.

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